New Zealand Medical Services in Middle East and Italy
Surgery in the Final Battles
Surgery in the Final Battles
In spite of the fact that many divisional medical officers were experiencing their first battle, the standard of treatment was high, few deficiencies being noted by the Consultant Surgeon 2 NZEF. At 1 Mobile CCS at Forli there was a steady turnover of casualties throughout the offensive, and at no time was there any difficulty in coping with the operative work. At times a small convoy of lighter cases was sent on by ambulance car to 1 General Hospital so as to ensure earlier operation. At other times the active MDS helped by dealing with lighter cases, as well as operating on those urgent cases normally dealt with at the MDS. The co-ordination between the MDS and the CCS was good. All head cases and maxillo-facial and eye injuries were sent to 66 British General Hospital at Riccione, where the special teams were kept very busy. Their results were very good, with almost complete absence of sepsis.
At first severe mine injuries were encountered and many leg and thigh amputations were performed. Then a series of severe abdominal cases was dealt with, many of them having also severe general injuries. Most of the deaths were in the abdominal group. A change to the horizontal position for the first twenty-four to forty-eight hours was made in the nursing of the abdominal cases at this period. This was more suitable for the shocked cases and facilitated nursing. The majority of cases operated on had X-ray films taken before operation, and the foreign bodies were generally removed. Parenteral penicillin was given to all wounds of any severity, including all abdominal cases.
At the base hospitals little sepsis was encountered and the delayed primary suture of wounds was carried out in the majority of cases with good results. A rapid turnover of patients was experienced and there were relatively few septic and toxic cases. The chest and head cases had done particularly well, with an almost complete absence of sepsis. Selected cases of nerve injury and cranial defect were operated on at 3 General Hospital so as to obviate delay, especially in the nerve cases, before operations could be carried out in New Zealand. The cranial defects were filled with bone chips from the crest of the ilium. At 3 General Hospital, and to page 663 a lesser extent at 1 General Hospital, closure of the colostomy in the abdominal wounds was undertaken in all suitable cases at this period. The results obtained were highly satisfactory, especially in those cases where an adequate spur had been made at the original operation.
There was a marked deficiency of trained anaesthetists in the Medical Corps at that time. Cyclopropane was being increasingly used, and it was considered that all the base hospitals as well as the CCS should possess an anaesthetic machine to enable cyclopropane to be administered to suitable cases.
The opinion of the Consultant Surgeon 2 NZEF (Colonel Stout) was that the treatment of war casualties at the end of the war in Europe had reached a very high level, both in the saving of life and in the freedom from sepsis and the rapid repair of wounds. To this progress the New Zealand Medical Corps had contributed its share and had rapidly adopted any progressive developments in treatment. The young medical officers in the forward areas had especially distinguished themselves by their painstaking and skilled work.
In mentioning the work of the New Zealand Medical Corps, recognition had to be given to the high standard of efficiency and conscientious work of the ‘other ranks’ of the Medical Corps, again especially in the forward areas. The nursing attention given by the men in the field ambulances and casualty clearing station was assiduous and capable, and many very serious cases were nursed through to safety without the benefit of being nursed by New Zealand sisters. The work of the sisters was held in the highest esteem by all, including the RAMC officers who had knowledge of their work.
Altogether, the work of the NZMC during the campaigns was thought to have been quite up to the high standard set by the RAMC; and in the forward areas the work, especially of the field ambulances, was perhaps a shade better.